WHY CHANGE TIMES? AMERICAN ACADEMY OF PEDIATRICS RECOMMENDATION. Middle & high school students should begin classes no earlier than 8:30 a.m.

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2 TONIGHT S AGENDA Research on School Start Times Start Times Study Committee Formation & Process Dr. Sarah Honaker, Director of Behavioral Sleep Medicine, Riley Hospital Mrs. Cheri O Day Marcotte, Asst. Superintendent at Wayne Twp. Schools Issues Discussed by Committee Schedule Options Survey Feedback via Today s Meet ( 2

3 WHY CHANGE TIMES? AMERICAN ACADEMY OF PEDIATRICS RECOMMENDATION Middle & high school students should begin classes no earlier than 8:30 a.m. Earlier start times impact: Sleep Optimal levels ( hours) Health Obesity, depression Learning Improved academic performance Biological factors include: Nocturnal melatonin secretion Shift in circadian rhythm 3

4 WHY CHANGE TIMES? 4

5 START TIMES PROCESS September 2016 School Start Time (SST) Committee Meeting Teachers, administrators, parents, community members Discussed considerations related to change, answers needed Developed structure for community forum October 2016 Community Forum & Survey November 2016 SST Committee Meeting Review survey results Discuss considerations, begin developing recommendation for School Board December 2016 SST Committee Meeting Finalize recommendation to School Board 5

6 START TIMES INFORMATION 6

7 START TIMES CHANGE Cheri O Day-Marcotte, EdS MSD of Wayne Township Assistant Superintendent for Elementary Schools Former Principal, Assistant Principal, & Teacher 7

8 MSD of Wayne Township School Starting and Ending Times Cheri O Day-Marcotte Assistant Superintendent for Elementary Schools 8

9 Some background about Wayne Far west side of Indianapolis Over 16,000 students Ben Davis High School, Ben Davis University, and Achieve Virtual Education Two 7 th and 8 th Grade Centers Ninth Grade Center Wayne Preparatory Program Alternative Sanders School Cooperative-5 Districts Area Districts Wayne Township Preschool 11 Elementary Schools 9

10 Our Timeline We made a few small changes for the school year, but needed more savings as our tax revenues declined. Our Superintendent, Dr. Jeffrey Butts challenged us with four leading questions. 10

11 1. How can we improve efficiencies in our transportation system and save additional tax dollars? 2. How can we improve our on-time pick-up and drop-off percentages? 3. How can we get as many of our elementary schools on the same time schedule as possible to improve PD opportunities for staff? 4. How can we be responsive to the research that older children learn better later in the day? 11

12 1. How can we improve efficiencies in our transportation system and save additional tax dollars? Studied all routes and stops and changed some drop off and pick up stops. (HARD) Consolidated routes eliminated 12 routes. Continued door to door for all special needs students. Currently have 114 General Ed buses running routes (Had 126) 12

13 2. How can we improve our on-time pick-up and drop-off percentages? Began monitoring with GPS and Here Comes the Bus tracking app! 13

14 Current Transportation Data Daily Routes 579 Daily Stops 8,397 Number of Buses Used 114 Number of Miles Traveled Daily 7,822 Number of Miles Traveled Per Year 1,423,682 14

15 3. How can we get as many of our elementary schools on the same time schedule as possible to improve PD opportunities for staff? 11 Elementary Schools on different schedules was difficult Now have 9 of the 11 on the same schedule (Two are later Horizons) 15

16 4. How can we be responsive to the research that older children learn better later in the day? In simplest terms have older students start later in the day! So what does that look like for Wayne? 16

17 School Starting and Ending Times (A) or First Tier: (9 Elementary Schools) School: Drop Off: Tardy Bell: Dismissal Begins: Buses Leave: Teacher Day: Office Hours: 9 Elem. 7:15 7:30 2:20 2:30 7:10 3:10 7:00 4:00 17

18 School Starting and Ending Times (B) or Second Tier: (2 Elem and 2 Secondary) School: Drop Off: Tardy Bell: Dismissal Begins: Buses Leave: Teacher Day: Office Hours: BDHS, NGC, 2 Elem. 8:15AM 8:30AM 3:20PM 3:30PM 7:30AM 3:30PM 7:15AM 4:15PM 18

19 School Starting and Ending Times (C) or Third Tier: (4 Secondary Schools) School: Drop Off: Tardy Bell: Dismissal Begins: Buses Leave: Teacher Day: Office Hours: CHC, LHC, WPA, and BDU 9:00AM 9:15AM 4:05PM 4:15PM 8:20AM 4:20PM 7:45AM 4:45PM 19

20 Additional notes: Concerns about after school care for younger students YMCA Extra Curricular events for secondary schools Concerns about bus stop darkness for all students. Some requests to transfer to a late school. Concerns about increased tardies for early schools. (Hasn t happened) Communication was key. 20

21 START TIMES RESEARCH Sarah M. Honaker, PhD, HSPP, CBSM Director of Behavioral Sleep Medicine, Riley Hospital Assistant Professor of Pediatrics, IU School of Medicine Specialties: Child & Adolescent Psychiatry 21

22 Adolescent Sleep Health and School Start Times Sarah Morsbach Honaker, Ph.D., CBSM Assistant Professor of Clinical Pediatrics IU School of Medicine Department of Pediatrics Pulmonology, Allergy, and Sleep Medicine

23 Moodiness Irritability What negative characteristics do you typically associate with adolescence? Impulsive decision making Low motivation Volatility

24 The Importance of Sleep Sleep is essential to health, safety, productivity and well being A sufficient amount to meet sleep needs and appropriately timed sleep is as important as nutrition and exercise The only thing that replaces sleep is: SLEEP Slide courtesy of Judy Owens MD

25 Sleep in School Aged Children Total sleep time: hours Low level of daytime sleepiness Circadian preference (chronotype): owl vs lark* School, activities, electronic media, later bedtimes, earlier rise times, irregular sleep/wake schedules preference Slide courtesy of Judy Owens MD

26 Sleep in Adolescents: Later Bedtimes All adolescents experience a normal shift in circadian rhythms with age and in association with the onset of puberty This results in a biologically based shift (delay) of up to several hours in both the natural fall sleep and morning wake times On a practical level, due to the forbidden zone this means that it s almost impossible for the average adolescent to fall asleep much before 11pm on a regular basis Teens cannot make themselves fall asleep earlier Slide courtesy of Judy Owens MD

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28 Carskadon Pediatr Clin N Am 2011;58:

29 Graphic Courtesy of Helene Emsellem, MD, Medical Director, Center for Sleep and Wake Disorders, Chevy Chase, Maryland

30 Distribution of Sleep Durations among 12,050 High School Students: US, 2013 Data Source: CDC. National Youth Risk Behavior Survey (YRBS) 2013

31 of Death 2010

32 Comparison of Selected Risk Behaviors among 12,154 High School Students, by Sleep Duration: YRBS, 2007 *All comparisons significant at p<0.05. Adapted from McKnight-Eily LR et al. Preventive Medicine 2011;53:

33 Sleep and Safety: Accidental Injuries Drowsy driving: Drivers years are involved in more than 50% of the 100,000 police reported fatiguerelated traffic crashes each year National poll: 68% of HS seniors have driven while drowsy; 15% at least 1x/wk Sleep loss impairments are equal or greater than those due to alcohol intoxication (ie, 3 4 beers) Sleep loss is associated with an increased risk of pedestrian injuries in children Sleep loss is associated with increased sports related injuries in high school students Sleep loss is associated with almost 3x risk in adolescents of work related injury requiring medical care Slide courtesy of Judy Owens MD

34 Can Lack of Sleep Be Fatal? In adults, short sleep duration is associated with significantly greater risk of all cause mortality (death due to any cause)*; U shaped curve First prospective cohort study of childhood sleep duration and lifelong mortality risk (2009) in a sample of healthy children followed from childhood throughout their entire lives** Eg, 16 year old male participants sleeping 3 hours less than the average (predicted) amount for their peers were at 2.34 times the all cause mortality risk Slide courtesy of Judy Owens MD

35 Adolescent Sleep Restriction Studies Verbal creativity Attention Complex problem solving & reasoning Teacher evaluated school performance Negative emotions, especially when given challenging tasks Sleepiness Unhealthy food choices Risk tasking Beebe, DW Ped Clin North Am. 2011;58:

36 Adolescent Sleep: The Bottom Line For optimal health, safety and achievement the average sleep high school student needs: hours of sleep 2016 AASM recommendations 8 10 hours for 13 18yo* 9 to 12 hours for children 6 12 years An early school start time makes it very difficult for most adolescents to consistently get enough sleep *Based on 10 month review by 13 sleep experts of published scientific evidence addressing the relationship between sleep duration and health (total of 864 scientific articles) Slide courtesy of Judy Owens MD

37 Is Sleep Education Effective? Authors Setting Format Improved Knowledge? Azevado et al HS Brazil min sessions Bakotic et al HS Croatia Educational Leaflet Cain et al HS Australia Four 50 min classes; MI Cortesi et al HS Italy 2 hour presentation de Sousa et al HS Brazil Five 50 min classes Harkins et al MS US Not reported Yes Yes Yes Yes Improved Patterns? Some; no control NA Other Yes No motivation Yes NA NA Yes; no control Kira et al HS New Zealand Four 50 min classes Moseley &Gradisar 2009 HS Australia Four 50 min classes Wing et al HS Hong Kong Multi modal; parents No Yes Yes No Yes No Energy drinks

38 The Role of School Start Times

39 Rationale for Later School Start Times

40 Brief History of SSTC Minnesota pioneers 1996: Edina MN changed high school start times from 7:20am to 8:30am 1997: Minneapolis changed high school start times from 7:15am to 8:40am; N>18,000 students Since late 1990 s, ~1000 high schools in >100 districts in 43 states report school start time delays; almost no schools have returned to the original bell times Slide courtesy of Judy Owens MD

41 Outcomes: Sleep Bedtimes remain the same or in some studies actually shift earlier Students obtain significantly more sleep More morning sleep The later the start time, the greater the sleep amounts But even a 30 minute delay results in improvements Students report less daytime sleepiness (falling asleep in class, doing homework) *Wheaton AG et al. J School Health 2016 Review of 38 reports examining the association between school start times, sleep, and behavioral, health and academic outcomes among adolescent students Slide courtesy of Judy Owens MD

42 Outcomes: School Performance* Attendance improves Tardiness rates drop Drop out rates decline Standardized test scores improve In one study SAT scores for the top 10% of students increased by more than 200 points Grades improve 5/6 schools showed significant increase in GPA pre post in English, math, science and SS Disadvantaged students may benefit more Larger effects of start times at lower end grade distribution** Effects of 1st period classes larger for black students*** *Wheaton AG et al 2016 **Edwards 2012 ***Cortes et al 2012 Slide courtesy of Judy Owens MD

43 Outcomes: Health & Safety Delayed SST are associated with improvements in: Mood (fewer report feeling unhappy, depressed) Health (decreased health center visits) Safety Kentucky: 7:30 to 8:40a start time; teens involved in car crashes down by 16% (vs 9% increase in the rest of the state) Virginia: Adolescent crash rates VA Beach (7:20a) vs Chesapeake (8:40a) 40% higher and peak 1 hour earlier CDC study (2014): Reduction crash rates in 16 18yo by as much as 65 70% (Minnesota, Colorado, Wyoming) Slide courtesy of Judy Owens MD

44 AAP Recommendation: Delay School Start Time until 8:30 am or Later Pediatrics 2014;134:

45 Barriers to Changing School Start Times Real Athletics scheduling with other teams and last class missed Younger children in AM darkness Childcare schedules for younger kids before and after school Parents work schedules Local traffic patterns Not Substantiated Athletics poorer outcomes Transportation costs higher After school activities decline After school employment negatively affected Teens stay up later at night

46 What Can Parents and Students Do? Appropriate light exposure Consistency between weekdays and weekends Parental limit setting

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48 Riley Sleep Disorders Center Behavioral Sleep Medicine Clinic Provider: Sarah Honaker, PhD Licensed Psychologist / Behavioral Sleep Medicine Specialist Short term intervention (2 4 sessions) Locations: Riley and IU Health North Behavioral Sleep Services include: Sleep scheduling and light therapy for circadian disturbances Behavioral plans for bedtime resistance, disruptive night wakings and other unwanted behaviors Child focused cognitive interventions for nighttime fears and anxiety Cognitive Behavioral Therapy for Insomnia Sleep training and support for families in helping infants and toddlers fall asleep independently PAP Adherence and desensitization

49 VERY Effective Counter Argument

50 Transition from Middle to High School Carskadon MA et al. 1998; Sleep:21; Compared sleep & circadian rhythms in students transitioning from middle school (8:25 school start time) to high school (7:20 start time); n=25 Sleep onset times did not change Avg sleep amount decreased from 7 hours 9 minutes to 6 hours 50 minutes Almost half of high schoolers studied (n=12) had an MSLT with SOREMs and an average 3 minute SOL, a pattern similar to that seen in narcolepsy.

51 Minnesota Wahlstrom K et al. CAREI Report 1998 NSF Report 2000 Adolescent Sleep Needs and Patterns Edina, 1996 Higher SES, suburban changed from 7:20 to 8:30 start time Minneapolis, 1997 (n=471) changed from 7:15 to 8:40 start time Lower SES, urban Compared data on multiple constructs to comparable test distracts (n=599) right after change and 3 years later

52 Minnesota 1 year findings Pre/Post Wahlstrom K et al. CAREI Report 1998 NSF Report 2000 Adolescent Sleep Needs and Patterns Improved attendance / decreased tardiness Fewer trips to school nurse Ate breakfast more often Increased TST by ~1 hour; did not stay up later as result of later school start time Teachers report more alert students Students report less sleepiness, better mood (suburban area only) Parents report teens are easier to live with

53 Minneapolis 3 Year Findings Wahlstrom K & Davidson ML. CAREI Report School Sleep Habits Survey readministered 3 years post change; also examined data from state repository School Functioning Findings Improved school attendance for all ethnic groups except Native Americans Slight improvement in grades, but not statistically significant Sleep Findings Initial gains maintained: 1 hour gain in TST per weeknight

54 Kentucky Danner FA & Phillips B. J Clin Sleep Med 2008:4; Fayette County; middle and high school start time change from 7:30 to 8:25 Increased TST by ~50 minutes 15% decrease in automobile crash rate for year olds (despite increase in other parts of the state) % of HS students getting at least 8 hours of sleep increased from 21% to 51%

55 Rhode Island Owens JA et al. Arch Ped Adol Med 2010:164; Independent high school in Rhode Island (n=201) moved start time from 8 to 8:30 am. 45 min mean increase in TST (7h7 to 7h52) and no change in sleep onset % sleeping >8 hours increased from 16.4% to 54.7% Reduced daytime sleepiness and fatigue Ex: took naps 52.4% to 36.3% Reduction in depressed mood Fewer health center visits for fatigue related complaints No change in grades

56 School Start Times: Key Findings Later school start times result in increased nocturnal sleep, ranging 45 min. to 1 hour 1 3 Improvements in tardiness/attendance 3 Better academic performance 1 Reduced daytime sleepiness 1,3 Improved mood 1 Increased overall health and healthy behaviors 123 Decreased automobile crash rate 2 1Wahlstrom K et al. CAREI Report Danner FA & Phillips B. J Clin Sleep Med 2008:4; Owens JA et al. Arch Ped Adol Med 2010:164;

57 Sleep in the Modern American Family National Sleep Foundation 2014 Poll Mean Sleep Duration on School Days and Use of Electronics at Night Sometimes on Always off or not in bedroom hours Television Tablet or smartphone MP3/music player/radio

58 Sleep in the Modern American Family National Sleep Foundation 2014 Poll Number of Electronic Devices in Bedroom Median devices: 6 11 years 1 device; years 2 devices; years 3 devices

59 Sleep in the Modern American Family National Sleep Foundation 2014 Poll Estimated average sleep duration on school nights by sleep related rules Parent says he/she: Has rules about Does not have rules about Bedtime Television Caffeine Smartphone or cell phone Computer/tablet Video games Parent says he/she: ALWAYS ENFORCES rules about DOESN T ALWAYS ENFORCE rules about Bedtime Television Caffeine Smartphone or cell phone Computer/tablet Video games

60 Sleep in the Modern American Family National Sleep Foundation 2014 Poll Number of sleep related rules by age

61 START TIMES CONSIDERATIONS Transportation Must have 60 minutes between drop-off or pick-up times of elementary/secondary Child care availability, affordability Students who work after school Extra-curricular participation, including athletics, music, clubs C9 impact 61

62 START TIMES SAMPLE SCHEDULES Current Schedule Middle: 7:30am- 2:40pm, 7 hours, 10 minutes High: 7:35am - 2:50pm, 7 hours, 15 minutes Elementary: 9:00am - 3:45pm, 6 hours, 45 minutes 1) 100% Schedule Flip Elementary: 7:30am - 2:15pm Middle: 9:00am - 4:10pm High: 9:05am - 4:20pm 2) Flip and Shift by 30 Minutes Elementary: 8:00am - 2:45pm Middle: 9:30am - 4:40pm High: 9:35am - 4:50pm 3) Flip and Shift by 30 Minutes, Close AM gap Elementary: 8:00am - 2:45pm Middle: 9:15am - 4:25pm High: 9:20am - 4:35pm 4) Flip and Shift by 30 minutes, Modify MS/HS Dismissal Elementary: 8:00am - 2:45pm Middle: 9:00am - 4:10pm High: 9:05am - 4:20pm 5) Shift by 30 Minutes Middle: 8:00am - 3:10pm High: 8:05am - 3:20pm Elementary: 9:30am - 4:15pm 6) Shift by 60 Minutes Middle: 8:30am - 3:40pm High: 8:35am - 3:50pm Elementary: 10:00am - 4:45pm 62

63 START TIMES DISCUSSION QUESTIONS & ANSWERS 63